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referral to the consultant. Early signs of breakdown were the subject of report in some cases.
There were others who were regarded as being unable to benefit from further psychiatric treatment
or who have resisted the assistance that psychiatrists or psychiatric social workers can give
them. It may be expedient for psychopaths to be returned to their homes when no further treatment
or hospitalisation is of any value to the patient but the burden of contending with them falls
first of all on the family and relatives. It is also inevitable that the one constant visitor to the
family, i.e. the health visitor, finds these cases come back to her or the special services health
visitor who with the family doctor help to sustain them and their worried relatives.
Student Health Visitors have been received for practical experience and observation visits for
three terms during the year. Each is attached to one health visiting team and arrangements for
continuity of visiting a few families are made. A balanced programme of special experience
connected with all aspects of health visiting including contacts with schools and social agencies
is also provided for them.
Special Services for Problem Families
Miss H.J. Howse, special services health visitor for the Hornsey part of the Area reports:-
"As so many agencies dealing with problem families of families with special difficulties
feel that even after intensive work any improvement obtained does not last, endeavour has been
made, where possible, to keep a check on the families dealt with. After 2¾ years the result of
my observations of some 28 families, having between them 105 children, is as follows:-
Children: -
Four who were in care" are now at home with their parents.
Two children who were rejected by their mothers have had to be taken into care.
Six children (three families) are in care because of severe mental illness of the mother.
Two children (of one family) are in institutions because they are imbeciles.
In all but one of the remainder of the cases the children have been kept together with their
own parents; the exception is with its grandparents.
It has been possible to keep 95 children at home with their parents and to bring home again
to their parents four children who were "in care".
Families:-
Fourteen families have had association with the N.S.P.C.C.
Twenty four parents have been under the supervision of probation officers, on probation
or in prison.
Twenty six parents suffer from mental illness or mental subnormality.
In dealing with problem families my experience has shown that;-
1. From the beginning every opportunity must be taken to get families back into and
supported by the community. This means helping them to improve their relationships
within their own families, with the schools their children attend and with all the
activities offered by religious and other institutions. The first few weeks of intensive
work when all the materials matters are being dealt with must be used to developsuch
a good relationship that the attitudes of the family may gradually be changed and the
services of the special worker be reduced.
2. When a family moves from furnished accommodation to unfurnished, secondhand furniture
must be obtained and the family persuaded not to buy anything on hire purchase.